Estimation of postoperative fluid requirements in infants and children.

A quadrant scheme is presented for estimating postoperative fluid volumes for replacement of internal fluid shifts (third space losses) in pediatric surgical patients undergoing major intraabdominal surgery. The benefits derived from using a prescribed postoperative fluid management program that includes this quadrant scheme are determined by analyzing a series of 50 consecutive patients managed by five senior general and thoracic surgical house officers. Although the program tended to overestimate the fluid needs of the patients relative to a predetermined optimal urine output level, all but two patients with septic complications were hemodynamically stable and none had complications due to the fluid administration program.